• Special Investigation Unit (SIU) Coding…

    CVS Health (Austin, TX)
    …legal, compliance, or rework projects. + Ensure staff provide detailed written summaries of medical record review findings and ensure the team articulates ... in determining correct coding and appropriate documentation during the review of medical records . This...+ A minimum of 5 years of experience in medical record review for coding… more
    CVS Health (08/08/25)
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  • Director - Credit Review Senior Group…

    Citigroup (Irving, TX)
    …an independent review and challenge of credit risk management. The BICR Credit Review Team Manager serves as the Team Manager responsible for oversight ... **Global Risk Review (GRR)** provides independent, objective, reliable, valued and...institution is desirable **Skills/Competencies:** + Demonstrated success as a manager including a track record of building… more
    Citigroup (06/04/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate… more
    Molina Healthcare (08/08/25)
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  • Utilization Review Specialist RN - FT Days

    Houston Methodist (Sugar Land, TX)
    …is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of ... or concurrently determines the appropriateness of inpatient or observation services following review of relevant medical documentation, medical guidelines,… more
    Houston Methodist (07/29/25)
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  • Utilization Review Nurse - Transition…

    Houston Methodist (Houston, TX)
    …is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of ... or concurrently determines the appropriateness of inpatient or observation services following review of relevant medical documentation, medical guidelines,… more
    Houston Methodist (07/25/25)
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  • Sr. Professional Liability Medical Claims…

    Providence (TX)
    …Insurance Program:** + Communicate with patients, claimants, caregivers, providers, leadership + Review and analyze medical records , interview witnesses, ... we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional,… more
    Providence (07/15/25)
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  • Medical Staff Services Manager

    AdventHealth (Mansfield, TX)
    …for all ages, and a growing business community. **The role you'll contribute:** The Medical Staff Manager is responsible for the management and supervision of ... staff leadership with which to assess competency and grant privileges. The Medical Staff Manager is responsible for overseeing the timeliness of obtaining… more
    AdventHealth (08/07/25)
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  • Hospital Account Manager - ( RN , PT , OT…

    Select Medical (Lakeway, TX)
    …of medical rehabilitation. They assess patients to determine individual care needs, review medical records and meet with hospital teams to coordinate ... for Rehabilitation - Lakeway** A joint venture with Select Medical & Baylor Scott & White Health Lakeway, TX...Stroke Certified_ **$10,000 sign-on bonus for full-time!** **Hospital Account Manager / Clinical Liaison (RN, OT, PT, or SLP)**… more
    Select Medical (08/02/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Marble Falls, TX)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...the facility's Home Therapies Program. + Maintains integrity of medical and operations records and complies with… more
    Fresenius Medical Center (08/08/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Houston, TX)
    …are communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records . + ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… more
    Fresenius Medical Center (07/30/25)
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